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In 2004, over 120 million birds died or were destroyed as a result of a current avian influenza type, the H5N1 strain. This number is higher than the combined total bird deaths of all prior highly pathogenic outbreaks recorded throughout the world over the last four decades.

The spring 2005 die-off of upwards of 6,000 migratory birds at a nature reserve in central China, caused by highly pathogenic H5N1, was highly unusual and probably unprecedented.

In the past, only two large die-offs in migratory birds, caused by highly pathogenic viruses, are known to have occurred: in South Africa in 1961 (H5N3) and in Hong Kong in the winter of 2002–2003 (H5N1).

When compared with H5N1 viruses from 1997 and early 2004, H5N1 viruses now circulating are more lethal to experimentally infected mice and to ferrets (a mammalian model) and survive longer in the environment.

Alpha 2-3 receptors are found in the guts of wild birds (their natural host) and domestic poultry. Those receptors are scarce in the human upper respiratory tract.CDC's Division of Media Relations (6/10/08)-http://www.cdc.gov/flu/avian/

Poultry being carried on the Siliguri-Darjeeling highway, that harbored the H5N1 virus, helped it to spread to a region where 4,000,000 poultry had previously been culled in West Bengal to decrease risk of Avian influenza.

Sources said that the Panchayat elections in West Bengal had severely affected the state's bird flu control and containment operations.

State officials in 4 districts did not want to intimidate villagers by taking away their birds.

This, they said, could cost their vote during upcoming elections. May 11, 2008 The Times of India Group

Despite the death or destruction of an estimated 150 million birds, the virus is now considered endemic in many parts of Indonesia and Viet Nam and in some parts of Cambodia, China, Thailand, and possibly also the Lao People’s Democratic Republic.

Ducks feed mainly on leftover rice grains in harvested paddy fields, so free-ranging ducks in both countries are moved to many different sites in line with rice harvest patterns.

Virus persistence is now increasingly confined to areas with intensive rice-duck agriculture in eastern and southeastern Asia.

"Mapping H5N1 highly pathogenic avian influenza risk in Southeast Asia: ducks, rice and people", Proceedings of the National Academy of Sciences of the United States (PNAS), http://www.fao.org/newsroom/en/news/2008/1000817/index.html

Coordination of services. Multi-sectoral procedures should be put in place to coordinate the work of agricultural, veterinary and public health services (and any other sectors deemed appropriate in a country context) and facilitate the exchange of laboratory and epidemiological data.

Control Measures experiencing their first outbreaks of H5N1 avian influenza-October 2005

Rapid culling of all infected or exposed birds,

proper disposal of carcasses,

the quarantining and rigorous disinfection of farms, and

the implementation of strict sanitary, or “bio-security”, measures

Control Measures experiencing their first outbreaks of H5N1 avian influenza-October 2005

Restrictions on the movement of live poultry, both within and between countries,

The logistics of recommended control measures are most straightforward when applied to large commercial farms, where birds are housed indoors, usually under strictly controlled sanitary conditions, in large numbers.

3. Standard well-fitted surgical masks should be used if high-efficiency N95 respiratory masks (NIOSH-certified N-95 or equivalent) are not available. Masks should be fit-tested and training in their use should be provided; 4. Goggles; 5. Rubber or polyurethane boots that can be disinfected or protective foot covers that can be discarded.

1. Be aware of the early clinical signs of H5N1 infection, but also understand that many other common diseases – of far less health concern – will show similar early symptoms.

2. Check for these signs (especially fever) each day during potential exposure and for 14 days after last exposure.

3. Communicate any symptoms to a designated local physician and provide background information on exposure history.

Symptoms experiencing their first outbreaks of H5N1 avian influenza-October 2005

Most patients infected with the H5N1 virus show initial symptoms of fever (38 C or higher) followed by influenza-like respiratory symptoms, including cough, rhinorrhea, sore throat, and (less frequently) shortness of breath.

Watery diarrhea is often present in the early stages of illness, and may precede respiratory symptoms by up to one week.

Gastrointestinal symptoms (abdominal pain, vomiting) may occur and headache has also been reported.

Challenges experiencing their first outbreaks of H5N1 avian influenza-October 2005

Disposal

Occupational health

Developing new wild bird surveillance program

Hunting?

Public perception – panic?

General Resources experiencing their first outbreaks of H5N1 avian influenza-October 2005

Links to Additional Information

http://www.pandemicflu.gov/ (managed by the Department of Health and Human Services)

http://www.cdc.gov/flu/avian/ (managed by the Centers for Disease Control and Prevention)

WHO Resources experiencing their first outbreaks of H5N1 avian influenza-October 2005